Purpose: To evaluate efficacy and quality of life in elderly patients who substituted brimonidine (Alphagan â) BID for their topical beta-blockers in their ongoing treatment regimen for glaucoma.
Methods: A multicenter, three-month, open-label, crossover evaluation of 48 geriatric patients. Patients were at least 65 years of age and had used a topical non-selective beta-blocker for at least 6 months prior to entering the study. Patients were queried on adverse events at each visit and completed a quality of life questionnaire at the final evaluation.
Results: In this geriatric cohort with a mean age of 76.2 years (range: 65-90), replacement therapy with brimonidine BID produced a mean intraocular pressure reduction of 2.33 mm Hg (13.3%) from the beta-blocker treated baseline (P<.0001). The mean duration of topical beta-blocker therapy was 6.5 years (range: 6 months-36 years). Of the patients who reported adverse events with beta-blocker therapy, 37.5% reported less fatigue and 50% reported improvement in ocular dryness after switching to brimonidine BID. In addition, 51.4% of patients found brimonidine to be more comfortable or soothing than their prior therapy and 48.6% were more satisfied overall. Thirty-eight percent reported having more energy after switching to brimonidine from topical beta-blockers.
Conclusion: In this geriatric population, the replacement of topical beta-blockers with brimonidine BID produced a significant decrease in IOP with fewer adverse events, greater quality of life, and greater patient satisfaction.
Financial/Commercial Interest: C5